the performance we use? i wish medical malpractice never occurred but it does. we're all human and when it does occur, people deserve to be compensated. if the best evidence was followed and everything was proper, then we just understand that that is part of our own human frailties. we desperately need to look at everything you have proposed whether it be held courts, safe harbors, evidence-based toward reform as a necessary adjunct to this value proposition. if we don't, we're going to be forever struggling with trying to contain that cost. it is a significant costs. i don't know of this $50 billion or more but it is not chump change. >> i spent my time as a naval officer in vietnam. i am struck how we take the idea we used in airplanes, a checklist and apply them to the delivery of health care. the other thing we did in naval aviation was if we have a problem, one of the systems or whatever, we did not hide it. we just broadcast throughout the navy. this happened on this flight and this mission. this is wh